Department of General Surgery, Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, China.
Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Biomed Pharmacother. 2019 Dec;120:109437. doi: 10.1016/j.biopha.2019.109437. Epub 2019 Oct 4.
Immune checkpoint inhibitors (ICPIs) and chimeric antigen receptor (CAR) T-cell therapy are two main promising methods of immunotherapy, which have become increasingly important in cancer treatment. After the wider application of these medicine in clinic, a range of immune related adverse events (irAEs) covering almost any system arouse the concern for being randomness and unpredictability. Even if most adverse events are mild and controllable after thoughtful management, the occurrence of life-threatening toxicities should not be ignored because of the insidious and atypical symptoms, which makes the early diagnosis even more challenging. In this review, a brief introduction of immunotherapy and mechanisms underlying irAEs is involved. We mainly focus on the early diagnostic method and recommended management of toxicities of different systems separately, and consequently maximized effectiveness of immunotherapy can be achieved.
免疫检查点抑制剂（ICPIs）和嵌合抗原受体（CAR）T 细胞疗法是两种主要的有前途的免疫疗法，在癌症治疗中变得越来越重要。这些药物在临床中更广泛地应用后，一系列涉及几乎所有系统的免疫相关不良事件（irAEs）引起了人们对其随机性和不可预测性的关注。即使在经过深思熟虑的管理后，大多数不良事件是轻微且可控的，但由于其隐匿和非典型的症状，仍不能忽视危及生命的毒性的发生，这使得早期诊断更加具有挑战性。在这篇综述中，我们简要介绍了免疫疗法和 irAEs 的作用机制。我们主要关注不同系统毒性的早期诊断方法和推荐的管理方法，从而最大限度地提高免疫疗法的效果。
